| NPI | 1245885938 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 225100000X Physical Therapist (Licence: WA PT60961276) | 
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MA 24447) | 
| Enumeration Date | 2019-08-08 | 
| Last Update Date | 2024-04-12 |